Stone formation in the augmented urinary bladder in childhood: the current state of the problem
Keywords:augmentation cystoplasty, bladder stones, laser cystolithotripsy, bladder exstrophy, neurogenic bladder
Purpose - to analyze the current state of the problem patients’ treatment with stones in the augmented bladder and recommend optimal approaches for their elimination, based on the literature data.
Augmentation cystoplasty is a surgical procedure used in adults and children with refractory bladder dysfunction, including, in particular, small bladder capacity, in whom conservative treatment has failed. The leading pediatric pathologies for which enterocystoplasty performed are neuropathic bladder and bladder exstrophy. The article examines the complications that arise, and the possibilities and advantages of endoscopic techniques in children compared to open surgery in view of compromised tissues due to congenital defects and previous surgical interventions. The cause of the main postoperative complications, such as metabolic disorders, hematuria syndrome, calculi formation, mucus formation, enteric fistulae, bladder rupture, intestinal obstruction and the development of malignant neoplasms, are mainly related to the use of gastrointestinal tract tissues in the bladder. As an example of modern surgical and minimally invasive methods application, considered the case of treatment of a child with urinary bladder exstrophy, in which later stones were formed.
Conclusions. The stones formation in an augmented bladder is a fairly common problem, difficult to prevent and effectively treat. Timely complete bladder emptying and adequate treatment of bladder infections are the keys to preventing the formation of stones in an augmented bladder. Modern minimally invasive technologies make it possible to effectively, minimally traumatical and safely treat patients with calculi of various localizations of the urinary system, as well as patients who have previously undergone complex plastic surgery.
The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies.
No conflict of interest was declared by the authors.
Athawale HR, Mane SB, Vagheriya NN, More P, Daginawala T. (2020). Ten years' experience of augmentation cystoplasty for varied indications and its outcome. Int Surg J. 7:1031-1035. https://doi.org/10.18203/2349-2902.isj20200999
Barashi NS, Rodriguez MV, Packiam VT, Gundeti MS. (2018). Bladder Reconstruction with Bowel: Robot-Assisted Laparoscopic Ileocystoplasty with Mitrofanoff Appendicovesicostomy in Pediatric Patients. J Endourol. 32 (S1): S119-S126. https://doi.org/10.1089/end.2017.0720; PMid:29774817
Chatterjee US, Chatterjee I. (2021). Percutaneous cystolithotomy in augmented bladders. J Indian Assoc Pediatr Surg. 26: 250-252. https://doi.org/10.4103/jiaps.JIAPS_128_20; PMid:34385769 PMCid:PMC8323569
Cohen AJ, Pariser JJ, Anderson BB, Pearce SM, Gundeti MS. (2015). The robotic appendicovesicostomy and bladder augmentation: the next frontier in robotics, are we there? Urol Clin North Am. 42 (1): 121-130. https://doi.org/10.1016/j.ucl.2014.09.009; PMid:25455178
EAU Guidelines. (2023). Edn. presented at the EAU Annual Congress Milan 2023. ISBN 978-94-92671-19-6.
Fan W et al. (2015). Mitomycin-C suppresses mucus secretion in an ileal neobladder rat model. Experimental and Therapeutic Medicine. 10: 598-602. https://doi.org/10.3892/etm.2015.2529; PMid:26622360 PMCid:PMC4509055
Fofanov OD, Jurtseva AP, Zinyak BM, Dotsenko YuR. Fofanov VO. (2021). The own experience of reconstructive-plastic operations on the bladder in children. Paediatric Surgery. Ukraine. 3 (72): 43-50. https://doi.org/10.15574/PS.2021.72.43
Gilbert SM, Hensle TW. (2005). Metabolic consequences and long term complications of enterocystoplasty in children: A review. J Urol. 173: 1080-1086. https://doi.org/10.1097/01.ju.0000155248.57049.4e; PMid:15758705
Gite VA, Siddiqui AK, Bote SM. (2015). Giant vesical calculus in augmented bladder with mitrofanoff procedure. Arch Int Surg. 5: 171-173. https://doi.org/10.4103/2278-9596.167513
Gundeti MS, Acharya SS, Zagaja GP, Shalhav AL. (2011). Paediatric robotic-assisted laparoscopic augmentation ileocystoplasty and Mitrofanoff appendicovesicostomy (RALIMA): feasibility of and initial experience with the University of Chicago technique. BJU Int. 107 (6): 962-969. https://doi.org/10.1111/j.1464-410X.2010.09706.x; PMid:20942829
Gundeti MS, Eng MK, Reynolds WS, Zagaja GP. (2008). Pediatric robotic-assisted laparoscopic augmentation ileocystoplasty and Mitrofanoff appendicovesicostomy: complete intracorporeal - initial case report. Urology. 72 (5): 1144-1147; discussion 1147. https://doi.org/10.1016/j.urology.2008.06.070; PMid:18804263
Gurocak S, Nuininga J, Ure I, De Gier RP, Tan MO, Feitz W. (2007). Bladder augmentation: review of the literature and recent advances. Indian journal of urology: IJU: journal of the Urological Society of India. 23 (4): 452. https://doi.org/10.4103/0970-1591.36721; PMid:19718303 PMCid:PMC2721579
Hayashi Y et al. (2006). Review of 86 Patients With Myelodysplasia and Neurogenic Bladder Who Underwent Sigmoidocolocystoplasty and Were Followed More Than 10 Years. J Urol. 176 (4): 1806-1809. https://doi.org/10.1016/j.juro.2006.03.123; PMid:16945655
Helmy TE et al. (2015). Treatment of Pouch Stones After Augmentation Ileocystoplasty in Children: Is It Always Bothersome? Urology. 85 (1): 195-198. https://doi.org/10.1016/j.urology.2014.09.021; PMid:25444630
Husmann DA. (2016). Long-term complications following bladder augmentations in patients with spina bifida: Bladder calculi, perforation of the augmented bladder and upper tract deterioration. Transl Androl Urol. 5: 3-11. doi: 10.3978/j.issn.2223-4683.2015.12.06.
Kisku S, Sen S, Karl S, Mathai J, Thomas RJ, Barla R. (2015). Bladder calculi in the augmented bladder: A follow-up study of 160 children and adolescents. Journal of Pediatric Urology. 11 (2): 66-e1. https://doi.org/10.1016/j.jpurol.2014.12.003; PMid:25819600
Kumar S, Jayant K. (2015). Massive Vesical Calculi Formation as a Complication of Augmentation Cystoplasty. Nephro-Urol. 7 (1): e22297. https://doi.org/10.5812/numonthly.22297
Langer S, Radtke C, Györi E, Springer A, Metzelder ML. (2019). Bladder augmentation in children: current problems and experimental strategies for reconstruction. Wiener Medizinische Wochenschrift (1946). 169 (3): 61-70. https://doi.org/10.1007/s10354-018-0645-z; PMid:30084093 PMCid:PMC6394595
Lapides J, Diokono AC, Silber SJ, Lowe BS. (1972). Clean intermittent selfcatheterization in the treatment of urinary tract disease. J Urol. 107: 458-461. https://doi.org/10.1016/S0022-5347(17)61055-3; PMid:5010715
Mehmood S et al. (2018). Long-term Outcomes of Augmentation Cystoplasty in a Pediatric Population with Refractory Bladder Dysfunction: A 12-Year Follow-up Experience at Single Center. Int Neurourol J. 22 (4): 287-294. https://doi.org/10.5213/inj.1836174.087; PMid:30599500 PMCid:PMC6312970
Metcalfe PD et al. (2006). What is the need for additional bladder surgery after bladder augmentation in childhood? The Journal of urology. 176 (4S): 1801-1805. https://doi.org/10.1016/j.juro.2006.03.126; PMid:16945653
Mikulicz J. (1889). Zur Operation der Augeborenen blasenspate. Zentrabl Chir. 26: 641.
Murthy P, Cohn A, Selig B, Gundeti S. (2015). Robot-assisted Laparoscopic Augmentation Ileocystoplasty and Mitrofanoff Appendicovesicostomy in Children: Updated Interim Results. Eur Urol. 68 (6): 1069-1075. https://doi.org/10.1016/j.eururo.2015.05.047; PMid:26187785
Ross JP, Keays M, Neville C, Leonard M, Guerra L. (2020). Pediatric bladder augmentation - Panacea or Pandora's box? Canadian Urological Association Journal. 14 (6): E251-256. https://doi.org/10.5489/cuaj.6024
Roth J, Keenan A, Cain M, Whittam B. (2015). Long-Term Sequela of Pediatric Bladder Reconstruction. Current Bladder Dysfunction Reports. 10 (4): 419-426. https://doi.org/10.1007/s11884-015-0336-1
Saadat S, Winkle D, Hirst J. (2018). Large bladder stone as a complication of AUS insertion and bladder augmentation. Urology Case Reports. 20: 15-16. https://doi.org/10.1016/j.eucr.2018.05.016; PMid:29963368 PMCid:PMC6022357
Salama AK et al. (2021). Incidence of nephrolithiasis after bladder augmentation in people with spina bifida. J Pediatr Urol. 17 (4): 521.e1-521.e7. https://doi.org/10.1016/j.jpurol.2021.03.012; PMid:33867288
Schlomer BJ, et al. (2014). Cumulative incidence of outcomes and urologic procedures after augmentation cystoplasty. J Pediatr Urol. 10: 1043-1050. https://doi.org/10.1016/j.jpurol.2014.03.007; PMid:24766857 PMCid:PMC4195808
Shevchuk DV. (2013). Surgical treatment of neuro-muscular dysfunction of bladder in children. Pediatric surgery. 4: 66-69.
Simon J. (1852). Extropia vesicae (absence of the anterior walls of the bladder and rubic abdominal parietes): Operation for directing the orifices of the ureters into the rectum: Temporary success: Subsequent death. autopsy. Lancet. 2: 568.
Sutojo B, Irdam GA. (2021). Safety of augmentation cystoplasty in patients with bladder abnormalities undergoing renal transplantation: a systematic review. Medical Journal of Indonesia. 30 (3): 198-206. https://doi.org/10.13181/mji.oa.204358
Szymanski KM et al. (2014). Cutting for stone in augmented bladders - what is the risk of recurrence and is it impacted by treatment modality? The Journal of urology. 191 (5): 1375-1380. https://doi.org/10.1016/j.juro.2013.11.057; PMid:24316089
Szymanski KM et al. (2016). Bladder stones after bladder augmentation are not what they seem. J Pediatr Urol. 12 (2): 98.e1-6. https://doi.org/10.1016/j.jpurol.2015.06.021; PMid:26455637
Szymanski KM et al. (2020). Additional Surgeries after Bladder Augmentation in Patients with Spina Bifida in the 21st Century. J Urol. 203 (6): 1207-1213. https://doi.org/10.1097/JU.0000000000000751; PMid:31951496
Thomas JS et al. (2018). Paediatric cystolitholapaxy through the Mitrofanoff/Monti channel. Journal of Pediatric Urology. 14 (5): 433-e1. https://doi.org/10.1016/j.jpurol.2018.02.024; PMid:29778700
Türk C, Skolarikos A, Donaldson JF et al. (2019). Guideline. Bladder Stones. European Association of Urology. URL: https://uroweb.org/guideline/bladder-stones/.
Yeates WK. (1956). A technique of ileocystoplasty. Br J Urol. 28: 410.
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